Annales françaises d'anesthèsie et de rèanimation
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The sitting position in neurosurgery may lead to complications such as air embolism and neurological complications. We report the case of a 16-year-old male who suffered from post-operation paraplegia after surgery for Arnold Chiari disease. This patient had several risk factors and serious morphological spinal abnormalities. We propose to include monitoring of somatosensory evoked potentials (SSEP) during this surgery in order to detect this type of devastating incident.
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Ann Fr Anesth Reanim · Jul 2002
[Evaluation of verification of brain death and coordination with hospital organ procurement at the University Hospital at Lille].
To determine the incidence of brain death (BD) and to evaluate the registration of potential organ donors (PD) by the organ procurement team (OPT). ⋯ The OPT was not called to manage one-third of the PD. The protocol for "systematic alert of the OPT when brain death is suspected" improves the call of the OPT and increases MOP.
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Ann Fr Anesth Reanim · Jul 2002
Case Reports[Autoantibodies and anti-factor VIII and Chlamydia pneumoniae infection].
We report the case of a 64-year-old man without hemorrhagic history experiencing epistaxis. The standard hemostasis assessment including prothrombin index, activated partial thromboplastin time (APTT) and platelet count found an isolated abnormal APTT (105 sec vs 33 sec). Therefore, coagulation factors were explored. ⋯ This anti-FVIII antibody was related to a Chlamydia pneumoniae pulmonary infection. Treatment consisted of: i) Four successive anterior packing and activated factor VII infusion (Novoseven); ii) steroids injection and bi-antibiotherapy. The time course of the epistaxis was favourable under treatment.
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A false hyperchloremia in a patient with a history of depression suspected bromide intoxication. The diagnosis was confirmed by an increased bromide concentration > 20 mmoL. ⋯ Rehydration was effective and allowed to decrease bromide concentration. In conclusion, hyperchloremia associated with a negative anion gap is a clue to the diagnosis.
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Ann Fr Anesth Reanim · Jul 2002
Case Reports[Fulminant mediastinitis from Streptococcus pneumoniae following cardiac surgery].
A 62-year-old patient was scheduled for coronary artery bypass surgery because of tritroncular coronary artery disease. The early postoperative period was uncomplicated until the 10th postoperative day when purulent fluid appeared from the sternal wound. ⋯ Despite prompt surgical debridement and appropriate antibiotics, a septic shock with multiorgan failure occurred and the patient died on the 19th postoperative day. Although Streptococcus pneumoniae is uncommonly implicated in postoperative mediatinitis, it frequently leads to multiple organ failure and death.